Excision of Skin Lesions

A lesion is an abnormal lump, bump or crack on the skin that can be malignant (cancerous) or benign (noncancerous). It can occur on the face, causing cosmetic problems. Your surgeon may recommend removal of the facial skin lesion as a treatment or for diagnostic purposes.

Some common benign skin lesions may include:

Haematoma

Naevi, commonly called moles

Squamous cell papilloma: strawberry marks present at birth

Common warts

Fibroma: associated with chronic trauma

Keratoacanthoma: can mimic malignant ulcer

Malignant tumours may include:

Basal-cell carcinoma: most common lesion that occurs due to sun damage

Squamous-cell carcinoma: can arise due to sun damage. May spread to local lymph nodes

Malignant melanoma: rare tumour that can spread to other body parts, making it very dangerous

Diagnosis

It is highly important to recognize and differentiate between benign and malignant lesions. Suspected malignant lesions are the ones that grow, spread or are pigmented. Your doctor will perform a physical examination (simple inspection and palpation) and remove a sample of tissue from the lesion to confirm under a microscope (biopsy).

Procedure

Almost all malignant skin lesions can be cured with early removal. Facial skin lesion removal is performed under a local anesthetic, which means you will be awake but will not feel any pain during your procedure. Your doctor will mark out the area on the skin to be removed. The lesion and a margin of healthy tissue around the lesion are removed to ensure that no malignant tissue is left behind. The wound left behind after the removal can be repaired by any of the following methods depending on the size of the wound:

Pulling together the surrounding skin with stitches

Transferring skin adjacent to the wound, known as a flap procedure

Transferring skin from a distant site (usually above the collarbone or behind the ear) known as a graft procedure

Care will be taken to maintain the aesthetic value of your face. Your doctor plans the removal and placement of skin flaps in your face's natural creases whenever possible.

Depending on the size of the lesion, the entire procedure may take 20 to 30 minutes to complete. The excised lesion may be sent to the laboratory for further analysis.

Post-operation

You may expect mild pain or discomfort once the effect of the local anesthetic wears out. You may be prescribed pain medications to control your pain. Antibiotic tablets or ointments will be prescribed to prevent infections. Some swelling or bruising is normal during the first two weeks after the procedure.

Your doctor may use a cotton wool pack over the skin graft to ensure proper healing. Sutures may be removed within 5 to 7 days and the pack may be removed after 10 to 14 days following your procedure.

Specific instructions on follow-up, wound care, and healing will be given to you by your surgeon.

Risks and complications

As all surgical procedures, facial skin lesion removal may be associated with certain risks and complications:

Bleeding after the surgery is fairly uncommon. Any minor bleeding can be stopped by applying pressure.

Infection may occur, for which your doctor may prescribe antibiotics.

Your surgeon will discuss with you the best method of wound closure depending on your specific procedure.